New Hampshire Acknowledgment of Receipt of COBRA Notice

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State:
Multi-State
Control #:
US-502EM
Format:
Word
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Description

This Employment & Human Resources form covers the needs of employers of all sizes.

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How to fill out Acknowledgment Of Receipt Of COBRA Notice?

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FAQ

Although the earlier rules only covered summary plan descriptions (SPDs) and summary annual reports, the final rules provide that all ERISA-required disclosure documents can be sent electronically -- this includes COBRA notices as well as certificates of creditable coverage under the Health Insurance Portability and

In addition, employers can provide COBRA notices electronically (via email, text message, or through a website) during the Outbreak Period, if they reasonably believe that plan participants and beneficiaries have access to these electronic mediums.

DOL ERISA Penalties An employer is liable up to an additional $110 per day per participant if they fail to provide initial COBRA notices. ERISA can also hold any fiduciary personally liable for non-compliance.

Are there penalties for failing to provide a COBRA notice? Yes, and the penalties can be substantial. Under the Employment Retirement Income Security Act of 1974 (ERISA), a penalty of up to $110 per day may be imposed for failing to provide a COBRA notice.

If You Do Not Receive Your COBRA PaperworkReach out to the Human Resources Department and ask for the COBRA Administrator. They may use a third-party administrator to handle your enrollment. If the employer still does not comply you can call the Department of Labor at 1-866-487-2365.

Initial COBRA notices must generally be provided within 14 days of the employer notifying the third-party administrator (TPA) of a qualifying event.

Federal COBRA & New Hampshire Continuation of Coverage Consolidated Omnibus Budget Reconciliation Act Continuation Coverage (COBRA) is a Federal law that gives employees and their covered dependents, who lose health benefits, the right to continue their coverage, in most cases, a maximum of 18 months.

COBRA is automatically available to you if you stop working at a qualified employer that provided group health insurance, but your participation in the program is not automatic. You must complete an enrollment form within the specified period of time and pay your first insurance premium.

Employers should send notices by first-class mail, obtain a certificate of mailing from the post office, and keep a log of letters sent. Certified mailing should be avoided, as a returned receipt with no delivery acceptance signature proves the participant did not receive the required notice.

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New Hampshire Acknowledgment of Receipt of COBRA Notice